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CPT code 29445: Total contact cast, rigid leg cast2026 Medicare rate & RVUs in Iowa

Reports application of a rigid total contact leg cast, commonly used to off-load a plantar foot ulcer by distributing pressure across the foot.

CMS RVU26DEffective Oct 1, 2026One payment locality16.2K Medicare services in 2024

In Iowa, Medicare pays $122.50 for 29445 in the office and $84.30 when it’s performed in a hospital or facility.

$122.50Office (non-facility)
$84.30Hospital or facility
−7.4%vs the national office rate ($132.27)

Check a contract rate as a % of Medicare · 29445 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 29445 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 29445 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 29445 covers

A rigid total contact cast is molded closely around the foot and lower leg to distribute pressure and limit movement. Podiatrists, orthopedists, and wound care clinicians most often apply it to off-load a plantar foot ulcer, including a neuropathic ulcer, in an office or facility setting. The close-fitting cast can support protected ambulation while reducing pressure on the affected area.

Select this code when the service is application of a rigid total contact cast, rather than a standard short leg cast, walking cast, or patellar tendon-bearing cast. Document the treated side, clinical indication and cast type, including the total-contact technique. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When bilateral services are reported with modifier 50, payment is at 150%. In a same-session multiple-procedure situation, the highest-valued procedure is paid in full and other procedures are reduced to 50%. An assistant at surgery is not paid; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Iowa compares for 29445

Across 109 of 109 payment localities, the office rate for 29445 runs from $119.51 in Arkansas to $165.38 in San Benito County, CA. Iowa pays $122.50. The RVUs are the same everywhere; the geographic indexes change the dollars.

29445 in Iowa vs other payment areas
  1. Iowa · this page$122.50
  2. Los Angeles, CA · California$144.75+$22.25
  3. Washington, DC area · District of Columbia$148.17+$25.67
  4. Miami, FL · Florida$145.25+$22.75
  5. Chicago, IL · Illinois$141.66+$19.16
  6. Manhattan, NY · New York$150.83+$28.33
  7. Alaska · Alaska$162.71+$40.21

Other areas in Iowa first, then benchmark localities. Bars start at $0.

Every other payment area

29445 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$120.93$84.40
ArkansasArkansas$119.51$83.65
ArizonaArizona$129.21$88.76
Bakersfield, CACalifornia$137.24$91.48
Chico, CACalifornia$136.63$90.87
El Centro, CACalifornia$136.67$90.91
Fresno, CACalifornia$136.63$90.87
Hanford, CACalifornia$136.63$90.87

29445 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$119.51

$162.71

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
29445 office rate range by state
State / territoryOffice rate rangeLocalities
AK$162.711
AL$120.931
AR$119.511
AZ$129.211
CA$136.63–$165.3829
CO$135.821
CT$140.031
DC$148.171
DE$131.071
FL$132.66–$145.253
GA$126.26–$134.862
GU$138.701
HI$138.701
IA$122.501
ID$123.351
IL$130.16–$141.664
IN$123.911
KS$122.481
KY$124.211
LA$124.23–$129.202
MA$135.42–$147.002
MD$133.11–$148.173
ME$124.34–$129.202
MI$127.26–$134.492
MN$129.521
MO$122.78–$129.043
MS$121.151
MT$132.251
NC$125.341
ND$128.301
NE$122.921
NH$134.201
NJ$141.45–$147.182
NM$128.011
NV$131.221
NY$126.91–$154.465
OH$126.451
OK$123.561
OR$130.01–$138.982
PA$126.37–$137.372
PR$132.911
RI$134.881
SC$126.141
SD$127.831
TN$123.031
TX$125.72–$135.548
UT$127.541
VA$129.16–$148.172
VI$132.911
VT$128.291
WA$135.00–$149.272
WI$124.811
WV$126.311
WY$130.531

See 29445 in every payment locality

How the 29445 rate is calculated

Each of 29445’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 29445

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.74

1.74 RVUs× 1.000 GPCI

Practice expense2.02

2.02 RVUs× 1.000 GPCI

Malpractice0.20

0.20 RVUs× 1.000 GPCI

Adjusted RVUs

3.9600

Conversion factor

$33.4009

Medicare rate

$132.27

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,295

Code
29445
Physician work
1.74
Practice expense
2.02
Malpractice
0.20

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 29445 in Iowa
ComponentRVULocality factorAdjusted
Physician work1.74× 1.0001.7400
Practice expense2.02× 0.9151.8483
Malpractice0.20× 0.3970.0794
Total RVUs3.6677
Conversion factor× 33.4009

Office rate, Iowa$122.50

Office: (1.74 × 1 + 2.02 × 0.915 + 0.2 × 0.397) × $33.4009 = $122.50

Facility: (1.74 × 1 + 0.77 × 0.915 + 0.2 × 0.397) × $33.4009 = $84.30

Open 29445 in the RVU calculator

Payment rules and modifiers for 29445

The CMS indicators that decide how 29445 is paid alongside other services.

CMS payment indicators · 29445

Total contact cast, rigid leg cast

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

29445 without 50 · national office

$132.27

Total contact cast, rigid leg cast

29445-50 · Bilateral: 150%

$198.41

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 29445

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 29445
CodeHow it relatesOffice range, Iowa
Used instead
29405Short leg cast, nonwalking castShort leg cast application without the rigid total contact cast distinction.$80.34
29425Walking cast, short legWalking short leg cast application when that cast type is used instead.$74.62
29435PTB cast, below kneePatellar tendon-bearing cast application for a different cast design and support approach.$126.56

How 29445 has changed in Iowa

29445 · Office / nonfacility

$122.50

Effective 2026-10-01

The base rate is $5.26 higher than on 2025-10-01, moving from $117.24 to $122.50 (4.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $117.24changed to$122.50

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.78 changed to 1.74
    • Practice expense RVU 1.93 changed to 2.02
    • Malpractice RVU 0.18 changed to 0.20
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $120.04changed to$117.24

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.90 changed to 1.93
    • Malpractice RVU 0.20 changed to 0.18

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $118.08changed to$120.04

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $120.21changed to$118.08

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.85 changed to 1.90
    • Malpractice RVU 0.19 changed to 0.20
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457

  5. January 1, 2023

    RVU23A

    $120.72changed to$120.21

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.79 changed to 1.85
    • Malpractice RVU 0.20 changed to 0.19
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $121.56changed to$120.72

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.78 changed to 1.79
    • Malpractice RVU 0.21 changed to 0.20

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $123.91changed to$121.56

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.72 changed to 1.78
    • Malpractice RVU 0.22 changed to 0.21
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $124.40changed to$123.91

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.75 changed to 1.72
    • Malpractice RVU 0.20 changed to 0.22
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $124.59changed to$124.40

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.76 changed to 1.75

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $127.38changed to$124.59

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.86 changed to 1.76
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $127.25changed to$127.38

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.87 changed to 1.86
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $128.71changed to$127.25

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.89 changed to 1.87
    • Malpractice RVU 0.22 changed to 0.20

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $128.07changed to$128.71

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $127.11changed to$128.07

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.86 changed to 1.89
    • Malpractice RVU 0.23 changed to 0.22
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $127.06changed to$127.11

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.08 changed to 1.86
    • Malpractice RVU 0.24 changed to 0.23
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $127.06

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$122.50$84.30RVU26D
2026-07-01$122.50$84.30RVU26C
2026-04-01$122.50$84.30RVU26B
2026-01-01$122.50$84.30RVU26A
2025-10-01$117.24$89.47RVU25D
2025-07-01$117.24$89.47RVU25C
2025-04-01$117.24$89.47RVU25B
2025-01-01$117.24$89.47RVU25A
2024-10-01$120.04$91.77RVU24D
2024-07-01$120.04$91.77RVU24C
2024-04-01$120.04$91.77RVU24B
2024-03-09$120.04$91.77RVU24AR
2024-01-01$118.08$90.28RVU24A
2023-10-01$120.21$92.15RVU23D
2023-07-01$120.21$92.15RVU23C
2023-04-01$120.21$92.15RVU23B
2023-01-01$120.21$92.15RVU23A
2022-10-01$120.72$93.73RVU22D
2022-07-01$120.72$93.73RVU22C
2022-04-01$120.72$93.73RVU22B
2022-01-01$120.72$93.73RVU22A
2021-10-01$121.56$94.97RVU21D
2021-07-01$121.56$94.97RVU21C
2021-04-01$121.56$94.97RVU21B
2021-01-01$121.56$94.97RVU21A
2020-10-01$123.91$98.38RVU20D
2020-07-01$123.91$98.38RVU20C
2020-04-01$123.91$98.38RVU20B
2020-01-01$123.91$98.38RVU20A
2019-10-01$124.40$98.58RVU19D
2019-07-01$124.40$98.58RVU19C
2019-04-01$124.40$98.58RVU19B
2019-01-01$124.40$98.58RVU19A
2018-10-01$124.59$99.12RVU18D
2018-07-01$124.59$99.12RVU18C
2018-04-01$124.59$99.12RVU18B
2018-01-01$124.59$99.12RVU18AR1
2017-10-01$127.38$99.86RVU17D
2017-07-01$127.38$99.86RVU17C
2017-04-01$127.38$99.86RVU17B
2017-01-01$127.38$99.86RVU17A
2016-10-01$127.25$99.66RVU16D
2016-07-01$127.25$99.66RVU16C
2016-04-01$127.25$99.66RVU16B
2016-01-01$127.25$99.66RVU16A
2015-10-01$128.71$100.70RVU15D
2015-07-01$128.71$100.70RVU15C
2015-04-01$128.07$100.20RVU15B
2015-01-01$128.07$100.20RVU15A
2014-10-01$127.11$99.95RVU14D
2014-07-01$127.11$99.95RVU14C
2014-04-01$127.11$99.95RVU14B
2014-01-01$127.11$99.95RVU14A
2013-10-01$127.06$97.78RVU13D
2013-07-01$127.06$97.78RVU13C
2013-04-01$127.06$97.78RVU13B
2013-01-01$127.06$97.78RVU13AR

Price 29445 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

29445 billing questions

When should I choose this code instead of 29405?

Use 29445 for a rigid total contact cast. Code 29405 describes application of a short leg cast without the total-contact distinction.

How does this differ from 29425?

Code 29425 is for a walking short leg cast. Choose 29445 when the service is specifically application of a rigid total contact cast, often for plantar pressure off-loading.

What documentation supports the code?

Record the indication, treated side, and that a rigid total contact cast was applied. For ulcer off-loading, identify the affected foot and ulcer site.

How is bilateral application reported?

For bilateral services, report modifier 50; CMS pays the bilateral procedure at 150%.

What same-day services are included or reduced?

Same-day preoperative and postoperative care is included in the 0-day global period. If multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 29445PPRRVU2026_Oct_nonQPP.csv, line 3,295 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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